Somewhere, at this very moment, a man’s wife agonizes as she receives a call from the police—her husband has been arrested for forging prescriptions for tranquilizers. In another community, a mother weeps as her adult daughter, intoxicated on painkillers, disrupts yet another family gathering. In a small Midwest town, a family is grieving the death of teen-age son who died at a party from an overdose of prescription anxiety medication and alcohol. The case scenarios go on and on. Legions of Americans are abusing and becoming addicted to prescription drugs.
In fact, chances are you know someone who is abusing prescription drugs. Maybe it’s your spouse, a relative, a friend, or a casual acquaintance. Maybe it’s you.
Addiction is a pattern of compulsive drug use characterized by a continued craving for drugs and the need to use these drugs for psychological effects or mood alterations. Many abusers find that they need to use drugs to feel “normal.” The user exhibits drug seeking behavior and is often preoccupied with using and obtaining the drugs of choice. These substances may be obtained through legal or illegal channels.
The American Society of Addiction Medicine considers addiction “a disease process characterized by the continued use of a specific psychoactive substance despite physical, psychological, or social harm.” Addiction is a chronic disease that is progressive—it worsens over time. It can be diagnosed and treated, but without treatment it is ultimately fatal.
How Addiction Affects the Brain
It was once thought that addiction was a result of being weak-willed—addicts could stop using drugs if they wanted to. But research has shown that this is not the case. In fact, after prolonged use of an addictive substance, the “circuits” in the brain virtually become “rewired.”
When a medication enters the brain, it is absorbed through receptor sites. Addictive drugs are believed to act on the brain by reinforcing the action of the body’s natural chemical, known as dopamine that is involved in producing the sensation of pleasure. When the body is getting such chemicals from an outside source,the brain stops making some of its own and becomes dependent on the outside source. As the brain adapts to the drug’s presence, the individual using the drug builds tolerance and must continually increase the dosage in order to achieve the initial pleasure sensations. However, most addicts in recovery report that they rarely achieved that initial sense of euphoria or feeling of well-being again.
Further, if the drug is stopped abruptly, it usually triggers withdrawal symptoms. Symptoms of withdrawal may vary depending on the length of the addiction and the drug being used, but common symptoms from painkillers may include anxiety, irritability, chills alternating with hot flashes, salivation, nausea, abdominal cramps, or even death. Some individuals describe withdrawal as the worst possible flu you can imagine. As one goes into withdrawal, the body “begs” for more of the addictive drug in order to escape the misery. Understandably, giving up the drug is difficult.
This inability to stop using the drug is a characteristic of addiction Although an addicted individual may intellectually understand the destructive consequences of addiction, he or she may not be able to stop the compulsive use of a drug; the changes in brain structure can affect emotions and motivation, both of which affect behavior.
Another common characteristic of addiction, denial, makes it even more difficult for the addicted individual to give up a drug. Denial refers to the addict’s belief that he or she really does not have a drug problem. This self-protective mechanism is governed by the subconscious areas of the brain where the main addiction pathways exist. Denial keeps the addict from acknowledging both the drug problem and the underlying emotional issues that may be influencing the use of drugs. Usually, the longer the drug abuse has gone on, the stronger the denial.
There are levels of drug abuse. Drug misuse refers to drugs unintentionally being used improperly by people hoping to get a therapeutic benefit from the drugs. Misuse includes many scenarios, ranging from the patient who stops taking a medication on his or her own, to the patient who may be exchanging drugs with family members or friends.
Medication misuse causes thousands of deaths and hospitalizations each year and the cost to the economy is in the billions of dollars. Another potentially fatal misuse of drugs involves painkillers or sedatives taken in combination with alcohol. Even though a drinker may have developed a tolerance to the sedative effects of alcohol, he or she will not have developed a tolerance for the alcohol’s depressing effects on the respiratory system. The combination of alcohol and tranquilizers or sedatives can create cardiorespiratory depression and lead to death.
Drug abuse refers to “the use, usually by self administration, of any drug in a manner that deviates from the approved medical use or social patterns within a given culture. The term conveys the notion of social disapproval, and it is not necessarily descriptive of any particular pattern of drug use or its potential adverse consequences,” according to The Pharmacological Basis of Therapeutics by Jerome Jaffe. Drug abuse may include using a medication “recreationally,” using it for reasons other than those intended, or using the drug more frequently than indicated by the prescriber. Abuse may or may not involve addiction.
It is estimated that as much as 28 percent of all prescribed controlled substances are abused. That estimate translates to tens of millions of drug doses being diverted annually for the purpose of abuse. Diversion refers to the redirecting of drugs from legitimate use into illicit channels. The drugs may be obtained through any number of sources—by bogus prescriptions, from a friend, or purchased on the streets.
How Many Americans Are Abusing Prescription Drugs?
It’s difficult to say with precision just how many Americans are abusing prescription drugs, although estimates are available. According to the Center for Disease Control and Prevention, nearly 12 million Americans aged twelve or older reported having used prescription drugs—painkillers, sedatives, tranquilizers, or stimulants—for nonmedical purposes during the year. Treatment for addiction to painkillers has increased 430 percent over the last decade.
Leading Cause of Accidental Death
Fatal poisonings from high concentrations of prescription medications have increased 400 percent in the United States over the past decade according to the Center for Disease Control Health Statistics. In fact, death from accidental overdose of prescription drugs is now the leading cause of accidental deaths among Americans. (Traffic accidents used to be the number one cause of accidental death.) Someone dies every nineteen minutes from drug overdose.
Deaths from prescription drugs first topped the list of causes of accidental deaths in 2008, when 41,000 Americans died as a result of drug poisoning, compared to 38,000 who died in automobile accidents.
Symptoms of Addiction
Prescription drug abuse is often difficult for friends and family to recognize. Contrary to popular belief, one need not abuse drugs daily to have a problem with addiction; the pattern of abuse may be occasional or habitual. The abuse is usually an intensely private affair between the abuser and a bottle of pills. And, the pill taker is not subject to the social stigma associated with the shadowy world of street-drug dealing. Still, the following are symptoms of addiction:
• Showing relief from anxiety
• Changes in mood—from a sense of well-being to belligerence
• False feelings of self-confidence
• Increased sensitivity to sights and sounds, including hallucinations
• Slurred speech, poor motor control
• Decline in hygiene and appearance
• Altered activity levels—such as sleeping for twelve to fourteen hours or frenzied activity lasting for hours
• Lack of interest in activities previously enjoyed
• Unpleasant or painful symptoms when the substance is withdrawn
• Preoccupation with running out of pills.
Who’s At Risk for Addiction?
Who is at risk for addiction? Medical science has also determined that those with a family history of addictions have about a threefold greater risk of developing addictions. But, in addition to family history, there are other risk factors.
The risk for addiction is greatest among women, seniors, and, as mentioned earlier, teenagers. Women are two to three times more likely than men to be prescribed drugs such as sedatives; they are also about two times more likely to become addicted. This stems in large part from the fact that women are more likely to seek medical attention for emotional problems. Seniors take more drugs than the rest of the population and have a reduced capability of breaking them down and eliminating them; this increases their odds of becoming addicted. And, the surge in teenage abuse of prescription drugs has led to dependency among many. Other groups at increased risk for addiction are medical professionals, alcoholics, and smokers.
Other factors that put one at risk for addiction:
• Medical condition that requires pain medication
• Extreme stress from family tragedy or death
• Excessive alcohol consumption
• Fatigue or overwork
• Poor self-image
Is everyone who takes addictive drugs at risk for addiction? The answer is no. Most people can do drugs with addiction potential and not progress to addiction; however, those who do become addicted likely have a preexisting addictive disorder, such as predisposition to alcoholism. The difficulty is, we don’t always know which patients this will be.”
Curbing the Epidemic of Addiction
Stopping the abuse of prescription drugs is a challenge, to say the least. However, in 2011, the Office of National Drug Control Policy released a multi-pronged strategy to deal with addiction to prescription drugs. The plan calls for consumer education, proper medication disposal, an increase in law enforcement activity, and monitoring programs that allow health professional to keep track of how many narcotics are being prescribed to patients.
Rod Colvin is the author of Overcoming Prescription Drug Addiction (Addicus Books).
A former journalist, he wrote the book after the death of his 35-year-old-brother Randy,
who died as a result of his long-term addiction to prescription drugs.
Currently the publisher at Addicus Books, Omaha, Nebraska, Colvin is also the
author of several other nonfiction books and numerous magazine articles. He may be
reached at info@AddicusBooks.com